Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review.
Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review.
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气溶胶生成程序和将急性呼吸道感染传播给医疗保健工作者的风险：系统评价。
DOI：
10.1371/journal.pone.0035797
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Conly J
中科院分区：
文献类型：
--
作者：
Tran K;Cimon K;Severn M;Pessoa-Silva CL;Conly J
气溶胶产生程序(AGP)可能使卫生保健工作者(HCW)暴露于引起急性呼吸道感染(ARI)的病原体，但从AGP传播ARIS的风险尚不完全清楚。我们试图确定ARIS传播给护理接受AGPS患者的卫生工作者的临床证据，并与传播给护理未接受AGPS患者的卫生工作者的风险进行比较。计算机检索PubMed、EMBASE、MEDLINE、CINAHL、Cochrane图书馆、约克大学CRD数据库、EuroScan、Lilacs、INTERNAL MEDLAR、Index Medicus for SE Asia、国际卫生技术机构和互联网上从1990年1月1日至2010年10月22日的文章，限定文章语言种类为英文。独立评价者使用预先定义的标准筛选摘要，获得全文文章，选择相关研究，并提取数据。分歧通过协商一致得到解决。利息的结果是ARI传播的风险。证据的质量使用分级系统进行评级。我们确定了5项病例对照和5项回顾队列研究，这些研究评估了SARS对卫生工作者的传播。报告的传播风险增加的方法包括[n；合并OR(95%CI)]气管插管[n = 4队列；6.6(2.3，18.9)，n = 4病例对照；6.6(4.1，10.6)]，无创呼吸机[n = 2队列；OR 3.1(1.4，6.8)]，气管切开[n = 1病例对照；4.2(1.5，11.5)]和插管前人工通气[n = 1队列；或2.8(1.3，6.4)]。其他插管相关操作，如气管内抽吸、体液抽吸、支气管镜检查、雾化治疗、吸氧、高流量氧气、操作氧气面罩或BiPAP面罩、除颤、胸外按压、插入鼻胃管、吸痰等均无明显差异。我们的发现表明，一些可能产生气雾剂的程序与SARS传播到卫生工作者的风险增加有关，或者是传播的风险因素，在多项研究中发现与气管插管的相关性最一致。
Aerosol generating procedures (AGPs) may expose health care workers (HCWs) to pathogens causing acute respiratory infections (ARIs), but the risk of transmission of ARIs from AGPs is not fully known. We sought to determine the clinical evidence for the risk of transmission of ARIs to HCWs caring for patients undergoing AGPs compared with the risk of transmission to HCWs caring for patients not undergoing AGPs. We searched PubMed, EMBASE, MEDLINE, CINAHL, the Cochrane Library, University of York CRD databases, EuroScan, LILACS, Indian Medlars, Index Medicus for SE Asia, international health technology agencies and the Internet in all languages for articles from 01/01/1990 to 22/10/2010. Independent reviewers screened abstracts using pre-defined criteria, obtained full-text articles, selected relevant studies, and abstracted data. Disagreements were resolved by consensus. The outcome of interest was risk of ARI transmission. The quality of evidence was rated using the GRADE system. We identified 5 case-control and 5 retrospective cohort studies which evaluated transmission of SARS to HCWs. Procedures reported to present an increased risk of transmission included [n; pooled OR(95%CI)] tracheal intubation [n = 4 cohort; 6.6 (2.3, 18.9), and n = 4 case-control; 6.6 (4.1, 10.6)], non-invasive ventilation [n = 2 cohort; OR 3.1(1.4, 6.8)], tracheotomy [n = 1 case-control; 4.2 (1.5, 11.5)] and manual ventilation before intubation [n = 1 cohort; OR 2.8 (1.3, 6.4)]. Other intubation associated procedures, endotracheal aspiration, suction of body fluids, bronchoscopy, nebulizer treatment, administration of O2, high flow O2, manipulation of O2 mask or BiPAP mask, defibrillation, chest compressions, insertion of nasogastric tube, and collection of sputum were not significant. Our findings suggest that some procedures potentially capable of generating aerosols have been associated with increased risk of SARS transmission to HCWs or were a risk factor for transmission, with the most consistent association across multiple studies identified with tracheal intubation.
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影响因子：
4.4
作者：
Hui DS;Chan PK
通讯作者：
Chan PK
影响因子：
4.2
作者：
Teleman, MD;Boudville, IC;Leo, YS
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作者：
Scales DC;Green K;Chan AK;Poutanen SM;Foster D;Nowak K;Raboud JM;Saskin R;Lapinsky SE;Stewart TE
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作者：
Wong TW;Lee CK;Tam W;Lau JT;Yu TS;Lui SF;Chan PK;Li Y;Bresee JS;Sung JJ;Parashar UD;Outbreak Study Group
通讯作者：
Outbreak Study Group